Which of the following statements about Medicare Part D are correct?
I. Part D plans must enroll any eligible beneficiary who applies regardless of health
status except in limited circumstances.
II. Private fee-for-service (PFFS) plans are not required to use a pharmacy network but
may choose to have one.
III. Beneficiaries enrolled in a MA-Medical Savings Account (MSA) plan may only
obtain Part D benefits through a standalone PDP.
IV. Beneficiaries enrolled in a MA-PPO may obtain Part D benefits through a
standalone PDP or through their plan.
Give this one a try later!
I, II, and III only
Mr. Gomez notes that a Private Fee-for-Service (PFFS) plan available in his area has an
attractive premium. He wants to know if he must use doctors in a network as his
current HMO plan requires him to do. What should you tell him?
,Give this one a try later!
He may receive health care services from any doctor allowed to bill
Medicare, as long as he shows the doctor the plan's identification card and
the doctor agrees to accept the PFFS plan's payment terms and conditions,
which could include balance billing.
Juan Hernandez is turning 65 next month, Juan legally entered the United States over
twenty years ago but is not a citizen. Since his entry into the country, Juan has worked
at Smallcap Incorporated and contributed to the Medicare system. Juan suffers from
diabetes. He will soon retire and asks you if he can enroll in a Medicare Advantage
plan that you represent. How would you respond?
Give this one a try later!
Juan is eligible to enroll in a Medicare Advantage as long as he is entitled
to Part A and enrolled in Part B. Juan should go to the Social Security
website to enroll in Medicare Part A and B if he has not done so already.
Once he is enrolled, he can choose a Medicare Advantage plan.
Mr. Wu is eligible for Medicare. He has limited financial resources but failed to qualify
for the Part D low-income subsidy. Where might he turn for help with his prescription
drug costs?
Give this one a try later!
Mr. Wu may still qualify for help in paying Part D costs through his State
Pharmaceutical Assistance Program.
, Melissa Meadows is a marketing representative for Best Care which has recently
introduced a Medicare Advantage plan offering comprehensive dental benefits for
$15 per month. Best Care has not submitted any potential posts to CMS for approval.
Melissa would like to use the power of social media to reach potential prospects.
What advice would you give her?
Give this one a try later!
Agent Meadows should post a tweet telling readers to contact her directly
to learn more about Best Care's comprehensive dental benefits at only $15
per month.
Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the
plan's terms and conditions for payment. Mary Rodgers sees Dr. Brennan for
treatment. How much may Dr. Brennan charge?
Give this one a try later!
Dr. Brennan can charge Mary Rogers no more than the cost sharing
specified in the PFFS plan's terms and condition of payment which may
include balance billing up to 15%of the Medicare rate.
Hector Hernandez is an independent agent. Hector sells plans on behalf of three
Medicare Advantage organizations that offer a total of 10 plans but does not
represent all Medicare Advantage organizations offering plans that are available in his
area. Which of the following statements best describes any steps Hector is required
to take?
Give this one a try later!
I. Part D plans must enroll any eligible beneficiary who applies regardless of health
status except in limited circumstances.
II. Private fee-for-service (PFFS) plans are not required to use a pharmacy network but
may choose to have one.
III. Beneficiaries enrolled in a MA-Medical Savings Account (MSA) plan may only
obtain Part D benefits through a standalone PDP.
IV. Beneficiaries enrolled in a MA-PPO may obtain Part D benefits through a
standalone PDP or through their plan.
Give this one a try later!
I, II, and III only
Mr. Gomez notes that a Private Fee-for-Service (PFFS) plan available in his area has an
attractive premium. He wants to know if he must use doctors in a network as his
current HMO plan requires him to do. What should you tell him?
,Give this one a try later!
He may receive health care services from any doctor allowed to bill
Medicare, as long as he shows the doctor the plan's identification card and
the doctor agrees to accept the PFFS plan's payment terms and conditions,
which could include balance billing.
Juan Hernandez is turning 65 next month, Juan legally entered the United States over
twenty years ago but is not a citizen. Since his entry into the country, Juan has worked
at Smallcap Incorporated and contributed to the Medicare system. Juan suffers from
diabetes. He will soon retire and asks you if he can enroll in a Medicare Advantage
plan that you represent. How would you respond?
Give this one a try later!
Juan is eligible to enroll in a Medicare Advantage as long as he is entitled
to Part A and enrolled in Part B. Juan should go to the Social Security
website to enroll in Medicare Part A and B if he has not done so already.
Once he is enrolled, he can choose a Medicare Advantage plan.
Mr. Wu is eligible for Medicare. He has limited financial resources but failed to qualify
for the Part D low-income subsidy. Where might he turn for help with his prescription
drug costs?
Give this one a try later!
Mr. Wu may still qualify for help in paying Part D costs through his State
Pharmaceutical Assistance Program.
, Melissa Meadows is a marketing representative for Best Care which has recently
introduced a Medicare Advantage plan offering comprehensive dental benefits for
$15 per month. Best Care has not submitted any potential posts to CMS for approval.
Melissa would like to use the power of social media to reach potential prospects.
What advice would you give her?
Give this one a try later!
Agent Meadows should post a tweet telling readers to contact her directly
to learn more about Best Care's comprehensive dental benefits at only $15
per month.
Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the
plan's terms and conditions for payment. Mary Rodgers sees Dr. Brennan for
treatment. How much may Dr. Brennan charge?
Give this one a try later!
Dr. Brennan can charge Mary Rogers no more than the cost sharing
specified in the PFFS plan's terms and condition of payment which may
include balance billing up to 15%of the Medicare rate.
Hector Hernandez is an independent agent. Hector sells plans on behalf of three
Medicare Advantage organizations that offer a total of 10 plans but does not
represent all Medicare Advantage organizations offering plans that are available in his
area. Which of the following statements best describes any steps Hector is required
to take?
Give this one a try later!
